这项工作得到了美国 (美国) #I01 BX000760 (肯尼迪) 的 VA 功绩审查的支持。退伍军人事务部 BLR & D。这项工作的内容并不代表美国政府退伍军人事务部的意见。

所有动物研究都获得了明尼阿波利斯 VA 医疗中心和明尼苏达大学的机构动物护理和使用委员会的批准。遵循目前的国家卫生研究院的使用和护理实验动物指南。
1. 冬眠手术
<ol><li>动物制剂<ol>
<li>要创建冬眠心肌模型, 使用5周的老, 女性, 约克郡猪, 它的重量在8-10 公斤的范围内以9.2 公斤作为平均重量。</li>
		<li>对于手术前的健康监测, 在手术前3天内对动物进行称量。</li>
		<li>在开始麻醉前将动物快速12小时。确保在任何时候都能为禁食的动物提供水。</li>
		<li>在手术前给予 SR 丁丙诺啡0.18 毫克/千克 IM 24 小时。</li>
	</ol></li>
	<li>感应<ol>
<li>用6.6 毫克/千克 tiletamine-zolazepam 和甲苯噻嗪鸡尾酒给予肌肉, 使动物镇静。允许5-15 分钟的药物鸡尾酒生效。</li>
		<li>用70% 异丙醇擦拭三倍于静脉注射导管, 制备耳静脉灌装。 注: 如果耳静脉不足, 可使用另一种外周静脉 (即头)。</li>
		<li>双眼涂抹眼部软膏, 防止角膜干燥。</li>
		<li>如有必要, 可通过管理1-2 毫克/千克丙泊酚 IV 或用3升/分钟的氧气和3% 异氟醚进行屏蔽, 以允许气管插管。 注意: 当眨眼反射或颚音缺失时, 动物被认为是适当的麻醉。</li>
		<li>用适当大小的气管导管插管动物。</li>
	</ol></li>
	<li>手术<ol>
<li>一旦动物被麻醉, 剃掉左胸区进行手术。</li>
		<li>以每分钟10-15 次呼吸来启动机械通气. 在1-4 升/分, 和异氟醚之间的1.0 和3.0% 之间设置氧气, 以维持手术平面的麻醉。</li>
		<li>把监控装置放在动物身上。监测设备应包括心电图, 血压, 温度和脉搏脉搏。</li>
		<li>将 iv 导管与0.9% 正常生理盐水的静脉注射液连接起来, 速度为5-10 毫升/千克/小时。</li>
		<li>灌装用 FDA 批准的手术磨砂准备左侧胸。</li>
		<li>每隔5-15 分钟对麻醉深度进行评估. 记录基线生命体征 (心率、心电图、2、血压、ETCO2和温度) 每15分钟。 注意: 当眨眼反射或颚音缺失时, 动物被认为是适当的麻醉。</li>
		<li>当动物躺在右侧时, 将不育的窗帘从脊柱的左侧放到肩胛骨上, 在无菌领域的第三个肋骨空间居中。 注: 无菌场涉及左前肩, 包括腋窝区继续到胸骨到第六肋空间 cranially。</li>
		<li>使用一个目标模式, 用 FDA 批准的手术方法 (如葡萄糖洗必泰) 或碘外科擦洗2分钟轻轻擦洗田间。</li>
		<li>用清水冲洗田野, 再用 FDA 批准的方法清洗两次, 2 分钟. 在洗涤之间用水冲洗手术场, 然后用无菌毛巾或 4 x 4 厘米纱布海绵将其干燥。</li>
		<li>用碘溶液喷洒区域, 用无菌窗帘将整个动物 (手术场除外) 披上。使用蒸汽或气体灭菌消毒的仪器, 礼服和窗帘的程序。</li>
		<li>在第二、第三和第四肋处使用0.3 毫升 0.5% bupivicaine 的肋间神经阻滞。</li>
		<li>在开胸前给125毫克的头孢唑啉 IV。 注: 1.5 毫克/千克司可林 IV 可作为麻痹剂, 以减少肌肉运动的每个外科医生的要求, 在打开胸腔。</li>
		<li>通过左开胸术暴露心脏。在心脏操作之前, 给2毫克/千克 IV 丸的利多卡因防止心律失常。用单烙做侧第三空间开胸切口。切口应从肩胛骨的颅骨侧面延伸至腋面积约10厘米. 使用烧灼切割皮肤和底层肌组织允许进入胸腔。</li>
		<li>放置一个 finochietto 肋骨牵引器, 进入胸腔的第三肋空间, 以收回肺。</li>
		<li>用 2-0 polyglactin 的缝合线将心包切开并缩回一侧, 露出童子动脉和静脉。用纱布覆盖的刮刀牵引器收回左心房附属物。</li>
		<li>使用虹膜剪刀, 打开膜在小伙子。</li>
		<li>坦率地解剖大约 0.25 cm 部分的童子动脉大约 1 cm 远端到小伙子和扬抑动脉结。用直角钳包围小伙子。</li>
		<li>在动脉周围放置两个4-0 聚酯缝合, 不施加任何张力。</li>
		<li>将一个直径为1.5 毫米的塑料 c 形蟒蛇置于第一对角线上, 而不阻塞该容器。</li>
		<li>保护它与两个4-0 聚酯领带包围的小伙子。</li>
		<li>松散关闭心包使用 2-0 polyglactin 缝合在一个简单的中断模式。</li>
		<li>在肋间肌层闭合时, 进行呼吸保持, 从胸部取出空气。仔细监测麻醉机上的气道压力表, 以保持在适当范围内的压力20-30 厘米的水和释放时完成。 注意: 这消除了手术后的胸管的需要。</li>
		<li>使用2-0 和3-0 可吸收缝线, 以标准的方式关闭肌肉和皮肤层。</li>
		<li>使用皮肤粘合剂在切口皮肤闭合。</li>
		<li>在手术结束时, 按照切口长度在多个部位管理1毫克/千克布比卡因肌肉的总剂量。在运输到回收区前管理 meloxicam 0.2 毫克/千克平方。</li>
		<li>当皮肤层关闭时, 将动物从呼吸机上断奶。</li>
		<li>把动物连接到麻醉机上, 直到它能自发地呼吸, 保护反射开始返回。</li>
		<li>不要取出气管导管, 直到动物吞下才能保护呼吸道。</li>
		<li>在切口上应用三抗生素软膏无菌、无粘附敷料。</li>
	</ol></li>
	<li>术后<ol>
<li>记录心率, 呼吸率, 体温和粘膜颜色每15分钟, 直到动物可以保持胸骨位置无可及。</li>
		<li>不要让动物无人看管, 直到它能举起并抬起头, 并且可以独立站立。</li>
		<li>给 meloxicam (0.2 毫克/千克) 皮下。</li>
		<li>管理持续释放丁丙诺啡6小时后, 最初的手术前剂量。</li>
		<li>将敷料留在切口上3天, 如果它保持清洁和干燥。如果衣服弄脏了就换掉。</li>
		<li>观察手术后5天的疼痛水平, 一般的健康状况和切口情况。 注意: 现在有一只小猪鬼脸秤可以用来评估这些动物术后的疼痛程度14。使用半剂量 meloxicam 每天需要一次突破疼痛。</li>
		<li>单人房的动物在恢复期的5天, 以限制活动, 并允许伤口愈合。</li>
		<li>允许8周充分发展冬眠心肌表型。</li>
	</ol></li>
</ol>2. 血管重建或关闭泵旁路
<ol><li>动物制剂<ol>
<li>在手术前3天内称动物体重。</li>
		<li>在手术前将动物快速12小时。确保在任何时候都能为禁食的动物提供水。</li>
		<li>在手术前给予持续释放丁丙诺啡0.18 毫克/千克肌肉24小时。</li>
	</ol>
</li>
	<li>感应<ol>
<li>用6.6 毫克/千克 tiletamine zolazepam/甲苯噻嗪鸡尾酒肌肉使动物镇静。镇静后5-15 分钟, 准备耳静脉灌装导管放置。 注: 如果耳静脉不足, 可使用另一种外周静脉 (即头)。</li>
		<li>双眼涂抹眼膏。</li>
		<li>1-2 毫克/千克丙泊酚诱导麻醉。</li>
		<li>用适当大小的气管导管插管动物。</li>
	</ol>
</li>
	<li>手术<ol>
<li>剃须动物的胸骨, 左侧胸和股骨三角形的手术。</li>
		<li>将机械通气设置为每分钟10-15 次呼吸, 氧气为1-4 升/分钟, 异氟醚在 1.0-3.0% 的情况下, 需要维持手术平面的麻醉。</li>
		<li>将监测设备 (心率、心电图、2、直接血压、ETCO2和温度) 放置在动物身上。</li>
		<li>将 iv 导管连接至 iv 滴, 并与正常生理盐水或系。</li>
		<li>灌装用聚维酮碘擦洗或其他 FDA 批准的方法准备皮肤。</li>
		<li>评估动物的麻醉深度。 注意: 当眼睛或颚反射没有时, 动物被认为是被深深麻醉的。</li>
		<li>定位动物背, 准备以前描述的皮肤, 用无菌毛巾将动物披上。</li>
		<li>对股动脉和插管进行切割。使用单烙创建一个大约3厘米皮肤切口在股动脉, 以揭露它的插管。</li>
		<li>在切口后进行股神经阻滞, 允许精确放置药物。将股骨套管连接到传感器, 以监测手术期间的血压。</li>
		<li>使用电烧灼切割从胸骨到剑突的过程, 以及切割肌肉, 脂肪和结缔组织到胸骨的水平。</li>
		<li>用振荡锯把胸骨分开。 注: 使用摆动锯, 而不是标准胸骨锯避免潜在的心肌损伤从心包粘连的结果, 切口的胸壁放置在小伙子。</li>
		<li>管理利多卡因 (2 毫克/千克 IV 负荷剂量, 50 µg/千克/分钟连续 IV 输液), 以防止心律失常。在500毫升的生理盐水中稀释利多卡因, 浓度为1毫克/毫升。</li>
		<li>用直梅奥剪刀将后胸骨板分开。</li>
		<li>用胸腔牵引器暴露胸腔。</li>
		<li>用单电烧灼的粘连。</li>
		<li>使用相同的牵引器, 与左胸骨边界温和海拔由助手, 解剖左内乳房动脉从胸壁。</li>
		<li>用 hemoclips 控制动脉分支。</li>
		<li>Heparinize 动物用100-300 单位/公斤肝素 iv。</li>
		<li>3分钟后, 将动脉与远端缝合。准备嫁接的近端。</li>
		<li>打开并收回心包。确认利马的长度足以到达该小伙子的适当的吻合口部位。</li>
		<li>使用带心脏稳定器、弹簧夹和适当大小的腔内装置的离泵技术, 执行利马到小伙子吻合7-0 聚丙烯缝合。</li>
		<li>在左侧胸的肋骨之间放置一个胸管, 外部化并附着在真空中, 从胸腔中取出空气15-30 分钟。</li>
		<li>用图八模式近似 #5 聚酯缝线的胸骨。</li>
		<li>关闭肌肉, 皮下和皮肤层在通常的方式, 如在冬眠手术中描述。取出胸管, 同时执行佛氏机动, 以消除任何残余空气从胸腔和关闭切口与一个皮肤缝合。</li>
		<li>在皮肤上涂抹皮肤粘合剂以保护胸骨切口。用7-0 聚丙烯缝线轻轻取出股骨导管, 用包绳模式修复动脉。使用 2-0 polyglactin 缝合在 subcuticular 模式下关闭皮肤。</li>
		<li>在手术结束时, 按照切口长度在多个部位管理1毫克/千克布比卡因肌肉的总剂量。</li>
		<li>在运输到回收区前, 管理 meloxicam 0.2 毫克/千克。</li>
		<li>在休眠过程中遵循操作后的协议。</li>
	</ol>
</li>
</ol>

<ol>
	<li>Mozaffarian, D., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Heart+Disease+and+Stroke+Statistics-2016+Update+A+Report+From+the+American+Heart+Association.">Heart Disease and Stroke Statistics-2016 Update A Report From the American Heart Association.</a> Circulation. 133 (4), 350 (2015).</li><li>Di Carli, M. F., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Value+of+metabolic+imaging+with+positron+emission+tomography+for+evaluating+prognosis+in+patients+with+coronary+artery+disease+and+left+ventricular+dysfunction.">Value of metabolic imaging with positron emission tomography for evaluating prognosis in patients with coronary artery disease and left ventricular dysfunction.</a> Am J Cardiol. 73 (8), 527-533 (1994).</li><li>Gerber, B. L., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Prognostic+value+of+myocardial+viability+by+delayed-enhanced+magnetic+resonance+in+patients+with+coronary+artery+disease+and+low+ejection+fraction:+impact+of+revascularization+therapy.">Prognostic value of myocardial viability by delayed-enhanced magnetic resonance in patients with coronary artery disease and low ejection fraction: impact of revascularization therapy.</a> J Am Coll Cardiol. 59 (9), 825-835 (2012).</li><li>McFalls, E., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Regional+glucose+uptake+within+hypoperfused+swine+myocardium+as+measured+by+positron+emission+tomography.">Regional glucose uptake within hypoperfused swine myocardium as measured by positron emission tomography.</a> Am J Physiol-Heart C. 272 (1), 343-349 (1997).</li><li>Velazquez, E. J., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Coronary-artery+bypass+surgery+in+patients+with+left+ventricular+dysfunction.">Coronary-artery bypass surgery in patients with left ventricular dysfunction.</a> New Engl J Med. 364 (17), 1607-1616 (2011).</li><li>Canty, J. M., Fallavollita, J. A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Hibernating+myocardium.">Hibernating myocardium.</a> J Nucl Cardiol. 12 (1), 104-119 (2005).</li><li>Joyce, D., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Revascularization+and+ventricular+restoration+in+patients+with+ischemic+heart+failure:+the+STICH+trial.">Revascularization and ventricular restoration in patients with ischemic heart failure: the STICH trial.</a> Curr Opin Cardiol. 18 (6), 454-457 (2003).</li><li>Shah, B. N., Khattar, R. S., Senior, R. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+hibernating+myocardium:+current+concepts,+diagnostic+dilemmas,+and+clinical+challenges+in+the+post-STICH+era.">The hibernating myocardium: current concepts, diagnostic dilemmas, and clinical challenges in the post-STICH era.</a> Eur Heart J. 34 (18), 1323-1336 (2013).</li><li>Stone, L. L. H., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Magnetic+resonance+imaging+assessment+of+cardiac+function+in+a+swine+model+of+hibernating+myocardium+3+months+following+bypass+surgery.">Magnetic resonance imaging assessment of cardiac function in a swine model of hibernating myocardium 3 months following bypass surgery.</a> J Thorac Cardiov Sur. , (2016).</li><li>Kukulski, T., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Implication+of+right+ventricular+dysfunction+on+long-term+outcome+in+patients+with+ischemic+cardiomyopathy+undergoing+coronary+artery+bypass+grafting+with+or+without+surgical+ventricular+reconstruction.">Implication of right ventricular dysfunction on long-term outcome in patients with ischemic cardiomyopathy undergoing coronary artery bypass grafting with or without surgical ventricular reconstruction.</a> J Thorac Cardiov Sur. 149 (5), 1312-1321 (2014).</li><li>Rahimtoola, S. H. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+hibernating+myocardium.">The hibernating myocardium.</a> Am Heart J. 117 (1), 211-221 (1989).</li><li>Fallavollita, J. A., Logue, M., Canty, J. M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Stability+of+hibernating+myocardium+in+pigs+with+a+chronic+left+anterior+descending+coronary+artery+stenosis:+absence+of+progressive+fibrosis+in+the+setting+of+stable+reductions+in+flow,+function+and+coronary+flow+reserve.">Stability of hibernating myocardium in pigs with a chronic left anterior descending coronary artery stenosis: absence of progressive fibrosis in the setting of stable reductions in flow, function and coronary flow reserve.</a> J Am Coll Cardiol. 37 (7), 1989-1995 (2001).</li><li>White, F. C., Carroll, S. M., Magnet, A., Bloor, C. M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Coronary+collateral+development+in+swine+after+coronary+artery+occlusion.">Coronary collateral development in swine after coronary artery occlusion.</a> Circ Res. 71 (6), 1490-1500 (1992).</li><li>Viscardi, A. V., Hunniford, M., Lawlis, P., Leach, M., Turner, P. V. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Development+of+a+Piglet+Grimace+Scale+to+Evaluate+Piglet+Pain+Using+Facial+Expressions+Following+Castration+and+Tail+Docking:+A+Pilot+Study.">Development of a Piglet Grimace Scale to Evaluate Piglet Pain Using Facial Expressions Following Castration and Tail Docking: A Pilot Study.</a> Front Vet Sci. 4, 51 (2017).</li><li>Holley, C. T., Long, E. K., Lindsey, M. E., McFalls, E. O., Kelly, R. F. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Recovery+of+hibernating+myocardium:+what+is+the+role+of+surgical+revascularization.">Recovery of hibernating myocardium: what is the role of surgical revascularization.</a> J Cardiac Surg. 30 (2), 224-231 (2015).</li><li>Cooper, H. A., Braunwald, E. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Clinical+importance+of+stunned+and+hibernating+myocardium.">Clinical importance of stunned and hibernating myocardium.</a> Coronary Artery Dis. 12 (5), 387-392 (2001).</li><li>McFalls, E. O., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Utility+of+positron+emission+tomography+in+predicting+improved+left+ventricular+ejection+fraction+after+coronary+artery+bypass+grafting+among+patients+with+ischemic+cardiomyopathy.">Utility of positron emission tomography in predicting improved left ventricular ejection fraction after coronary artery bypass grafting among patients with ischemic cardiomyopathy.</a> Cardiology. 93 (1-2), 105-112 (2000).</li><li>Pasquet, A., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Prediction+of+global+left+ventricular+function+after+bypass+surgery+in+patients+with+severe+left+ventricular+dysfunction.+Impact+of+pre-operative+myocardial+function,+perfusion,+and+metabolism.">Prediction of global left ventricular function after bypass surgery in patients with severe left ventricular dysfunction. Impact of pre-operative myocardial function, perfusion, and metabolism.</a> Eur Heart J. 21 (2), 125-136 (2000).</li></ol>

作者没有什么可透露的。

在这里, 我们表明, 我们的猪模型, 准确地模仿病人的临床经验, 单血管疾病和保留左心室功能。在血管重建之前, 单血管的动物在全球功能上表现出最小的损伤, 以弹射分数来衡量, 但区域壁增厚明显减少。在血管重建术后, 三月的 CMR 成像显示保留的生存能力和移植通畅性, 但持续的区域功能障碍, 如低剂量多巴酚丁胺压力测试的收缩储备的估计指出。
初始休眠操作有几个关键?...

冠心病 (CHD) 影响了估计在美国的1550万人1 , 是全球死亡的主要原因之一。虽然近年来冠心病的死亡率下降了, 但病人和保健系统的发病率和负担仍然很高1。严重 CAD 的初级治疗是血管重建, 改善生存和减少心绞痛2,3,4。然而, 心脏功能往往仍然压抑, 特别是在增加的工作量和可能进展到心力衰竭5,6。冠状动脉旁路手术 (CABG) 治疗慢性缺血的临床试验表明, 生存和症状有改善, 但弹射分数仅显示 8-10% 7,8的适度改善。我们的创新性和良好特征的猪慢性心肌缺血模型是一个渐进性血管狭窄的临床 CAD 模型。我们已经表明减少的心肌收缩力导致的血液流量的逐步减少9。心肌不梗塞, 可以保持在这种情况下可行。恢复是可能的, 虽然结果是可变的, 即使及时的血管重建。长期缺血性心肌仍然可行的特点是减少血流量和功能休息与保留收缩储备已被称为 HM 和治疗需要冠状动脉搭桥术。虽然 HM 重建术应恢复收缩功能, 实验和临床观察表明, 恢复不完整8,10。
HM 的特点是存在的可行的, 但功能失调的心肌存在减少区域血流11。尽管在休息时收缩力和新陈代谢活动受损, 但在强心剂刺激下, 他能够表现出功能性和新陈代谢的储备12。在大多数的冠心病患者中都有怀疑, 包括广泛的疾病。在这项协议中, 我们展示了我们建立的猪模型, 它绕过左内乳动脉 (利马) 到童子动脉, 模仿临床情况。猪提供了一个很好的模型的心脏疾病超过其他大型动物, 因为他们没有心外膜桥接络。这允许小男孩的狭窄导致区域缺血13。
在这里, 我们描述了通过在童子动脉中创建单血管狭窄来诱导猪冬眠心肌的手术方法。当慢性缺血已经建立 (8 周后植入的小伙子蟒蛇), 我们描述了重建的方法, 在我们的猪模型的临床治疗: 非体外循环冠状动脉旁路移植。这些手术方法不仅可用于研究慢性心肌缺血的临床相关模型, 还可以探讨旁路手术对心脏缺血的影响, 以及试验电位交替或辅助治疗心肌缺血的疗效。

<table border="0" cellpadding="0" cellspacing="0" style="width:1155px;" width="1154">
	<colgroup>
		<col />
		<col />
		<col />
		<col />
	</colgroup>
	<tbody>
		<tr height="21">
			<td height="21" style="height:21px;width:261px;">Bair Hugger</td>
			<td style="width:223px;">3M</td>
			<td style="width:203px;">Model 505</td>
			<td style="width:468px;">Patient Warming system</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:261px;">SR Buprenorphine 10 mg/mL</td>
			<td style="width:223px;">Abbott Labs</td>
			<td style="width:203px;">NADA 141-434</td>
			<td>Post operative Analgesic</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:261px;">Surgical Spring Clip</td>
			<td>Applied Medical</td>
			<td>A1801</td>
			<td>Clamp end of LIMA after takedown</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:261px;">Arterial Line Kit</td>
			<td>Arrow</td>
			<td>ASK-04510-HF</td>
			<td>Femoral catheter for blood pressure monitoring</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:261px;">1000mL 0.9% Sodium chloride</td>
			<td>Baxter</td>
			<td>2B1324X</td>
			<td>IV replacement fluid</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:261px;">250 mL 0.9% saline</td>
			<td>Baxter</td>
			<td>&#160;UE1322D</td>
			<td>Replacement IV Fluid&#160;</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:261px;">500mL 0.9% Sodium chloride</td>
			<td>Baxter</td>
			<td>2B1323Q</td>
			<td>Drug delivery, Provide mist for Blower Mister</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:261px;">Flo-thru 1.0</td>
			<td>Baxter</td>
			<td>FT-12100</td>
			<td>used to anastomos LIMA to L</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:261px;">Flo-thru 1.25</td>
			<td>Baxter</td>
			<td>FT-12125</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:261px;">Flo-thru 1.5</td>
			<td>Baxter</td>
			<td>FT-12150</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:261px;">Flo-thru 2.0</td>
			<td>Baxter</td>
			<td>FT-12200</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:261px;">Cloroprep</td>
			<td style="width:223px;">Becton Dickenson</td>
			<td style="width:203px;">260815</td>
			<td>Surgical skin prep</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:261px;">Meloxicam</td>
			<td>Boehringer Ingelheim Vetmedica, Inc.</td>
			<td>0010-6013-01</td>
			<td>NSAID for analgesia</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:261px;">Hypafix</td>
			<td>BSN Medical</td>
			<td>4210</td>
			<td>Secure wound dressing and IV catheters</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:261px;">IV Tubing for Blower Mister</td>
			<td>Carefusion</td>
			<td>42493E</td>
			<td>Adapts to IV Fluids for Blower/Mister</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:261px;">Bovie Cautery hand piece&#160;</td>
			<td>Covidien</td>
			<td>E2516</td>
			<td>Hemostasis&#160;</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;">Chest Tube</td>
			<td>Covidien</td>
			<td>8888561043</td>
			<td>Evacuates air from chest cavity&#160;</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:261px;">Monopolar Cautery&#160;</td>
			<td>Covidien</td>
			<td>Valleylab FT10</td>
			<td>Hemostasis&#160;</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:261px;">Telpha pad</td>
			<td style="width:223px;">Covidien</td>
			<td style="width:203px;">2132</td>
			<td>Sterile wound dressing</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:261px;">4-0 Tevdek II Strands</td>
			<td style="width:223px;">Deknatel</td>
			<td style="width:203px;">7-922</td>
			<td>Suture to secure constrictor around LAD</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:261px;">Propofol</td>
			<td style="width:223px;">Diprivan</td>
			<td style="width:203px;">269-29</td>
			<td>Induction agent</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:261px;">&#160;long blade for laryngoscope&#160;</td>
			<td style="width:223px;">DRE</td>
			<td>12521</td>
			<td>Allows for visualization of trachea for intubation</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:261px;">ECG Pads</td>
			<td>DRE</td>
			<td>1496</td>
			<td>Monitor heart rhythm</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:261px;">laryngoscope&#160;</td>
			<td style="width:223px;">DRE</td>
			<td>12515</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:261px;">Anesthesia Machine + ventilator</td>
			<td style="width:223px;">DRE Drager- Fabius Tiro</td>
			<td style="width:203px;">DRE0603FT</td>
			<td>Deliver Oxygen and inhalant to patient</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:261px;">&#160;5 Ethibond&#160;</td>
			<td>Ethicon</td>
			<td>MG46G</td>
			<td>Suture</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:261px;">0 Vicryl</td>
			<td>Ethicon</td>
			<td>J208H</td>
			<td>Suture</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:261px;">2-0 Vicryl</td>
			<td>Ethicon</td>
			<td>J317H</td>
			<td>Suture</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:261px;">3-0 Vicryl</td>
			<td>Ethicon</td>
			<td>VCP824G</td>
			<td>Suture</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:261px;">7-0 Prolene</td>
			<td>Ethicon</td>
			<td>M8702</td>
			<td>Suture</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:261px;">Dermabond</td>
			<td style="width:223px;">Ethicon</td>
			<td>DNX12</td>
			<td>Skin adhesive</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:261px;">Ligaclips</td>
			<td>Ethicon</td>
			<td>MSC20</td>
			<td>Surgical Staples for LIMA takedown</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:261px;">Sterile Saline 20 mL</td>
			<td>Fisher Scientific</td>
			<td>20T700220</td>
			<td>Flush for IV catheters</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:261px;">Telazol 100 mg/mL</td>
			<td style="width:223px;">Fort Dodge</td>
			<td style="width:203px;">01L60030</td>
			<td>Pre operative Sedative</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:261px;">Triple Antibiotic Ointment</td>
			<td style="width:223px;">Johnson &#38; Johnson</td>
			<td style="width:203px;">23734</td>
			<td>Topical over wound</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:261px;">6.0 mm ID endotracheal tube</td>
			<td>Mallinckrodt</td>
			<td>86049</td>
			<td>Establish airway for Revasc,MRI and Termination</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:261px;">1&#34; medical tape</td>
			<td style="width:223px;">Medline</td>
			<td>MMM15271Z</td>
			<td>Secure wound dressing and IV catheters</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:261px;">4.0 mm ID endotracheal tube</td>
			<td>Medline</td>
			<td>DYND43040</td>
			<td>Establish airway for Hibernation</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:261px;">4.5 mm ID endotracheal tube</td>
			<td>Medline</td>
			<td>DYND43045</td>
			<td>Establish airway for Hibernation</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:261px;">5.0 mm ID endotracheal tube</td>
			<td>Medline</td>
			<td>DYND43050</td>
			<td>Establish airway for Hibernation</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:261px;">6.5 mm ID endotracheal tube</td>
			<td>Medline</td>
			<td>DYND43065</td>
			<td>Establish airway for Revasc,MRI and Termination</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:261px;">7.0 mm ID endotracheal tube</td>
			<td>Medline</td>
			<td>DYND43070</td>
			<td>Establish airway for Revasc,MRI and Termination</td>
		</tr>
		<tr height="42">
			<td height="42" style="height:42px;width:261px;">Bair Hugger Blanket -&#160; Large size, underbody</td>
			<td>Medline</td>
			<td>AUG55501</td>
			<td>Patient Warming system</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:261px;">Basic pack</td>
			<td style="width:223px;">Medline</td>
			<td style="width:203px;">DYNJP1000</td>
			<td>Sterile drapes and table cover</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:261px;">Bone Wax</td>
			<td>Medline</td>
			<td>ETHW31G</td>
			<td>Hemostasis of cut bone</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;">Suction&#160; tubing</td>
			<td>Medline</td>
			<td>DYND50223</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:261px;">Suction Container&#160;</td>
			<td>Medline</td>
			<td>DYNDCL03000</td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:261px;">1 mL Syringe</td>
			<td style="width:223px;">Medtronic/Covidien</td>
			<td>1188100777</td>
			<td>Administer injectable agents</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:261px;">12 mL Syringe</td>
			<td style="width:223px;">Medtronic/Covidien</td>
			<td>8881512878</td>
			<td>Administer injectable agents</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:261px;">20 mL Syringe</td>
			<td style="width:223px;">Medtronic/Covidien</td>
			<td>8881520657</td>
			<td>Administer injectable agents</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:261px;">3 mL Syinge</td>
			<td style="width:223px;">Medtronic/Covidien</td>
			<td>1180300555</td>
			<td>Administer injectable agents</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:261px;">6&#160; mL Syringe</td>
			<td style="width:223px;">Medtronic/Covidien</td>
			<td>1180600777</td>
			<td>Administer injectable agents</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:261px;">60 mL Syringe</td>
			<td style="width:223px;">Medtronic/Covidien</td>
			<td>8881560125</td>
			<td>Administer injectable agents</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;">Blower Mister Kit</td>
			<td>Medtronic/Covidien</td>
			<td>22120</td>
			<td>Clears surgical field for vessel anastomosis</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:261px;">Roncuronium</td>
			<td>Mylan</td>
			<td>67457-228-05</td>
			<td>Neuromuscular blocking agent</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:261px;"># 40 clipper blade</td>
			<td>Oster</td>
			<td>078919-016-701</td>
			<td>Remove hair from surgery sites</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:261px;">Hair Clipper</td>
			<td>Oster</td>
			<td>078566-011-002</td>
			<td>Remove hair from surgery sites</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;">Bupivicaine</td>
			<td>Pfizer</td>
			<td>00409-1161-01</td>
			<td>Local Anesthetic</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:261px;">Cephazolin</td>
			<td>Pfizer</td>
			<td>00409-0805-01</td>
			<td>Antibiotic</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;">Heparin&#160;</td>
			<td>Pfizer</td>
			<td>&#160;0409-2720-03</td>
			<td>anticoaggulant</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:261px;">Lidocaine 2%</td>
			<td>Pfizer</td>
			<td>00409-4277-01</td>
			<td>Local Anesthetic/ antiarrthymic</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:261px;">Succinylcholine 20 mg/mL</td>
			<td style="width:223px;">Pfizer</td>
			<td style="width:203px;">00409-6629-02</td>
			<td>Neuromuscular blocking agent</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:261px;">Anesthesia Monitor</td>
			<td>Phillips&#160; Intellivue&#160;</td>
			<td style="width:203px;">MP70&#160;</td>
			<td>Supports ventilation with inhalant</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:261px;">Artificial Tears</td>
			<td style="width:223px;">Rugby</td>
			<td style="width:203px;">0536-1086-91</td>
			<td>Lubricate eyes to prevent corneal drying</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:261px;">Buprenorphine 0.3 mg/mL</td>
			<td style="width:223px;">Sigma Aldrich</td>
			<td style="width:203px;">B9275</td>
			<td>Pre operative Analgesic for survivial procedures</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:261px;">Isoflurane</td>
			<td style="width:223px;">Sigma Aldrich</td>
			<td style="width:203px;">CDS019936</td>
			<td>General Anesthestic- Inhalant</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;">36&#8221; Pressure monitoring tubing</td>
			<td>Smith&#8217;s Medical</td>
			<td>MX563</td>
			<td>Connect art. Line&#160; to transducer</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;">48&#8221; Pressure monitoring tubing</td>
			<td>Smith&#8217;s Medical</td>
			<td>MX564</td>
			<td>Connect art. Line&#160; to transducer</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:261px;">Jelco 18 ga IV catheter&#160;</td>
			<td style="width:223px;">Smiths medical</td>
			<td style="width:203px;">4054</td>
			<td>IV access in Revasc, MRI and Term</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:261px;">Jelco 20 ga IV catheter</td>
			<td style="width:223px;">Smiths medical</td>
			<td style="width:203px;">4059</td>
			<td>IV access in the MRI</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:261px;">Jelco 22 ga&#160; IV catheter</td>
			<td style="width:223px;">Smiths medical</td>
			<td>4050</td>
			<td>IV access in Hibernation Procedure</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;">OPVAC Synergy II</td>
			<td>Terumo Cardiovascular System</td>
			<td>401-230</td>
			<td>Heart positioner and Stabilizer</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:261px;">Sternal Saw/ Necropsy Saw</td>
			<td>Thermo Fisher</td>
			<td>812822</td>
			<td>Used to open chest cavity</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:261px;">Delrin Constrictor</td>
			<td style="width:223px;">U of MN</td>
			<td style="width:203px;">Custom made</td>
			<td>Creates stenosis of LAD</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:261px;">Oxygen Tank E cylinder</td>
			<td>various</td>
			<td>various</td>
			<td>Used for Blower Mister if anesthesia machine doesn&#39;t have auxiliary flow meter</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:261px;">Pressure Transducer</td>
			<td>various</td>
			<td>Must adapt to anesthesia monitor</td>
			<td>Monitor direct arterial pressures</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:261px;">Xylazine 100 mg/mL</td>
			<td style="width:223px;">Vedco</td>
			<td style="width:203px;">468RX</td>
			<td>Pre operative Sedative/ analgesic</td>
		</tr>
	</tbody>
</table>

surgical swine model of chronic cardiac ischemia treated by off-pump coronary artery bypass graft surgery

慢性心肌缺血损害心功能, 但不导致梗塞, 称为冬眠心肌 (HM)。冠状动脉疾病 (CAD) 患者的一个大的临床子集有, 除了造成功能受损, 使他们在心律失常和未来心脏事件更高的风险。这种情况的标准治疗是血管重建, 但这已被证明是一个不完善的治疗。大多数临床前心脏研究的重点是梗死模型的心脏缺血, 留下这个子集的慢性缺血患者大多缺乏服务。为了解决这一研究中的差距, 我们开发了一种具有良好特征和高度可重复性的猪冬眠心肌模型, 因为猪是人类心脏疾病的理想转化模型。除了建立这种独特的疾病模型, 我们已经优化了一个临床相关的治疗模式的冠状动脉旁路手术的猪。这使我们能够准确地研究旁路手术对心脏疾病的影响, 以及调查其他或替代疗法。该模型通过在一只年轻的猪的左前降 (童子) 动脉内植入一个小蟒蛇来手术诱导单血管狭窄。随着猪的生长, 蟒蛇造成了逐渐的狭窄, 导致慢性缺血的区域功能受损, 但保持组织的生存能力。在冬眠心肌表型的建立后, 我们进行非体外循环冠状动脉旁路移植手术, revascularize 缺血性区域, 模仿临床患者的金本位治疗。

在最初的冬眠手术后, 临床成像技术, 如血管造影或心脏 MRI (图 1A) 可以观察到大于70% 的狭窄。手术后8周, 回声或心脏 MRI 对区域功能的分析显示在增加的工作负载下功能减少 (图 2)。这可以通过刺激心脏与多巴酚丁胺 (5 毫克/千克/分钟), 并测量周向应变和区域壁厚。PET 成像显示, 与同一心脏的非童子领地相比, 冬眠?...

Watch this Scientific Journal Video about Surgical Swine Model of Chronic Cardiac Ischemia Treated by Off-Pump Coronary Artery Bypass Graft Surgery at JoVE.com

Surgical Swine Model of Chronic Cardiac Ischemia Treated by Off-Pump Coronary Artery Bypass Graft Surgery

该协议提出了一种外科大动物模型, 慢性, 单血管缺血, 导致区域异常, 但不会造成梗塞, 称为冬眠心肌。在慢性缺血的建立后, 动物用非泵浦的利马-小伙子冠状动脉旁路移植术治疗 revascularize 缺血性组织。

非体外循环冠状动脉旁路移植术治疗慢性心肌缺血的外科猪模型

Chronic cardiac ischemia that impairs cardiac function, but does not result in infarct, is termed hibernating myocardium (HM). A large clinical subset of ...

surgical-swine-model-chronic-cardiac-ischemia-treated-off-pump

Research

JoVE Journal

Medicine

9.4K 次观看.  University of Minnesota. 该协议提出了一种外科大动物模型, 慢性, 单血管缺血, 导致区域异常, 但不会造成梗塞, 称为冬眠心肌。在慢性缺血的建立后, 动物用非泵浦的利马-小伙子冠状动脉旁路移植术治疗 revascularize 缺血性组织。

视频: Surgical Swine Model of Chronic Cardiac Ischemia Treated by Off-Pump Coronary Artery Bypass Graft Surgery

Implantation of Inferior Vena Cava Interposition Graft in Mouse Model

Biodegradable scaffolds seeded with bone marrow mononuclear cells (BMCs) are often used for reconstructive surgery to treat congenital cardiac anomalies. The long-term clinical results showed excellent patency rates, however, with significant incidence of stenosis. To investigate the cellular and molecular mechanisms of vascular neotissue formation and prevent stenosis development in tissue engineered vascular grafts (TEVGs), we developed a mouse model of the graft with approximately 1 mm internal diameter. First, the TEVGs were assembled from biodegradable tubular scaffolds fabricated from a polyglycolic acid nonwoven felt mesh coated with &#949;-caprolactone and L-lactide copolymer. The scaffolds were then placed in a lyophilizer, vacuumed for 24 hr, and stored in a desiccator until cell seeding. Second, bone marrow was collected from donor mice and mononuclear cells were isolated by density gradient centrifugation. Third, approximately one million cells were seeded on a scaffold and incubated O/N. Finally, the seeded scaffolds were then implanted as infrarenal vena cava interposition grafts in C57BL/6 mice. The implanted grafts demonstrated excellent patency (&#62;90%) without evidence of thromboembolic complications or aneurysmal formation. This murine model will aid us in understanding and quantifying the cellular and molecular mechanisms of neotissue formation in the TEVG.

To improve our knowledge of cellular and molecular neotissue formation, a murine model of the TEVG was recently developed. The grafts were implanted as infrarenal vena cava interposition grafts in C57BL/6 mice. This model achieves similar results to those achieved in our clinical investigation, but over a far shortened time-course.

下腔静脉间置移植物在小鼠模型中植入

Biodegradable scaffolds seeded with bone marrow mononuclear cells (BMCs) are often used for reconstructive surgery to treat congenital cardiac anomalies. ...

科研

医学

Evaluation of a Novel Laser-assisted Coronary Anastomotic Connector - the Trinity Clip - in a Porcine Off-pump Bypass Model

To simplify and facilitate beating heart (i.e., off-pump), minimally invasive coronary artery bypass surgery, a new coronary anastomotic connector, the Trinity Clip, is developed based on the excimer laser-assisted nonocclusive anastomosis technique. The Trinity Clip connector enables simplified, sutureless, and nonocclusive connection of the graft to the coronary artery, and an excimer laser catheter laser-punches the opening of the anastomosis. Consequently, owing to the complete nonocclusive anastomosis construction, coronary conditioning (i.e., occluding or shunting) is not necessary, in contrast to the conventional anastomotic technique, hence simplifying the off-pump bypass procedure. Prior to clinical application in coronary artery bypass grafting, the safety and quality of this novel connector will be evaluated in a long-term experimental porcine off-pump coronary artery bypass (OPCAB) study. In this paper, we describe how to evaluate the coronary anastomosis in the porcine OPCAB model using various techniques to assess its quality. Representative results are summarized and visually demonstrated.

This paper describes a novel nonocclusive coronary anastomotic connector in a porcine off-pump coronary artery bypass (OPCAB) model. This easy-to-use coronary connector has intrinsic potential to facilitate minimally invasive OPCAB surgery.

评价一种新型激光辅助冠状动脉吻合口连接器 - 三位一体夹 - 在猪非体外循环旁路模式

To simplify and facilitate beating heart (i.e., off-pump), minimally invasive coronary artery bypass surgery, a new coronary anastomotic connector, the ...

Ultrasound Based Assessment of Coronary Artery Flow and Coronary Flow Reserve Using the Pressure Overload Model in Mice

Transthoracic Doppler echocardiography (TTDE) is a clinically useful, noninvasive tool for studying coronary artery flow velocity and coronary flow reserve (CFR) in humans. Reduced CFR is accompanied by marked intramyocardial and pericoronary fibrosis and is used as an indication of the severity of dysfunction. This study explores, step-by-step, the real-time changes measured in the coronary flow velocity, CFR and systolic to diastolic peak velocity (S/D) ratio in the setting of an aortic banding model in mice. By using a Doppler transthoracic imaging technique that yields reproducible and reliable data, the method assesses changes in flow in the septal coronary artery (SCA), for a period of over two weeks in mice, that previously either underwent aortic banding or thoracotomy. 
During imaging, hyperemia in all mice was induced by isoflurane, an anesthetic that increased coronary flow velocity when compared with resting flow. All images were acquired by a single imager. Two ratios, (1) CFR, the ratio between hyperemic and baseline flow velocities, and (2) systolic (S) to diastolic (D) flow were determined, using a proprietary software and by two independent observers. Importantly, the observed changes in coronary flow preceded LV dysfunction as evidenced by normal LV mass and fractional shortening (FS). 
The method was benchmarked against the current gold standard of coronary assessment, histopathology. The latter technique showed clear pathologic changes in the coronary artery in the form of peri-coronary fibrosis that correlated to the flow changes as assessed by echocardiography. 
The study underscores the value of using a non-invasive technique to monitor coronary circulation in mouse hearts. The method minimizes redundant use of research animals and demonstrates that advanced ultrasound-based indices, such as CFR and S/D ratios, can serve as viable diagnostic tools in a variety of investigational protocols including drug studies and the study of genetically modified strains.

Coronary flow reserve (CFR) is useful for assessment of myocardial oxygen demand and evaluation of cardiovascular risk. This study establishes a step-by-step transthoracic Doppler echocardiographic (TTDE) method for longitudinal monitoring of the changes in CFR, as measured from coronary artery in mice, under the experimental pressure overload of aortic banding.

冠脉流量和冠状动脉血流储备用小鼠压力超负荷基于模型的超声评估

Transthoracic Doppler echocardiography (TTDE) is a clinically useful, noninvasive tool for studying coronary artery flow velocity and coronary flow ...

Vein Interposition Model: A Suitable Model to Study Bypass Graft Patency

Bypass grafting is an established treatment method for coronary artery disease. Graft patency continues to be the Achilles heel of saphenous vein grafts. Research models for bypass graft failure are essential for a better understanding of pathobiological and pathophysiological processes during graft patency loss. Large animal models, such as pigs or sheep, resemble human anatomical structures but require special facilities and equipment. This video describes a rat vein interposition model to investigate vein graft patency loss. Rats are inexpensive and easy to handle. Compared to mouse models, the convenient size of rats permits better operability and enables a sufficient amount of material to be obtained for further diverse analysis. In brief, the inferior epigastric vein of a donor rat is harvested and used to replace a segment of the femoral artery. Anastomosis is conducted via single stitches and sealed with fibrin glue. Graft patency can be monitored non-invasively using duplex sonography. Myointimal hyperplasia, which is the main cause for graft patency loss, develops progressively over time and can be calculated from histological cross sections.

This video demonstrates a model to study the development of myointimal hyperplasia after venous interposition surgery in rats.

静脉介入型号:研究旁路移植通畅一个合适的模型

Bypass grafting is an established treatment method for coronary artery disease. Graft patency continues to be the Achilles heel of saphenous vein grafts. ...

A Chronic Cardiac Ischemia Model in Swine Using an Ameroid Constrictor

Cardiovascular disease remains the number one cause of mortality in the United States. There are numerous approaches to treating these diseases, but regardless of the approach, an in vivo model is needed to test each treatment. The pig is one of the most used large animal models for cardiovascular disease. Its heart is very similar in anatomy and function to that of a human. The ameroid placement technique creates an ischemic area of the heart, which has many useful applications in studying myocardial infarction. This model has been used for surgical research, pharmaceutical studies, imaging techniques, and cell therapies.
There are several ways of inducing an ischemic area in the heart. Each has its advantages and disadvantages, but the placement of an ameroid constrictor remains the most widely used technique. The main advantages to using the ameroid are its prevalence in existing research, its availability in various sizes to accommodate the anatomy and size of the vessel to be constricted, the surgery is a relatively simple procedure, and the post-operative monitoring is minimal, since there are no external devices to maintain. This paper provides a detailed overview of the proper technique for the placement of the ameroid constrictor.

The purpose of this protocol is to demonstrate the placement of a delayed constricting device (an ameroid constrictor) around a coronary artery in a swine model. This device creates an ischemic area of the heart that is useful for studying new diagnostic imaging techniques and new methods of treatment.

应用 Ameroid 的猪慢性心肌缺血模型

Cardiovascular disease remains the number one cause of mortality in the United States. There are numerous approaches to treating these diseases, but ...

Tachycardia-Induced Cardiomyopathy As a Chronic Heart Failure Model in Swine

A stable and reliable model of chronic heart failure is required for many experiments to understand hemodynamics or to test effects of new treatment methods. Here, we present such a model by tachycardia-induced cardiomyopathy, which can be produced by rapid cardiac pacing in swine.
A single pacing lead is introduced transvenously into fully anaesthetized healthy swine, to the apex of the right ventricle, and fixated. Its other end is then tunneled dorsally to the paravertebral region. There, it is connected to an in-house modified heart pacemaker unit that is then implanted in a subcutaneous pocket. 
After 4 - 8 weeks of rapid ventricular pacing at rates of 200 - 240 beats/min, physical examination revealed signs of severe heart failure - tachypnea, spontaneous sinus tachycardia, and fatigue. Echocardiography and X-ray showed dilation of all heart chambers, effusions, and severe systolic dysfunction. These findings correspond well to decompensated dilated cardiomyopathy and are also preserved after the cessation of pacing.
This model of tachycardia-induced cardiomyopathy can be used for studying the pathophysiology of progressive chronic heart failure, especially hemodynamic changes caused by new treatment modalities like mechanical circulatory supports. This methodology is easy to perform and the results are robust and reproducible.

Here, we present a protocol to produce tachycardia-induced cardiomyopathy in swine. This model represents a potent way to study the hemodynamics of progressive chronic heart failure and the effects of applied treatment.

心动过速诱发的心肌病作为猪慢性心力衰竭模型的研究

A stable and reliable model of chronic heart failure is required for many experiments to understand hemodynamics or to test effects of new treatment ...

Brachial Artery Catheterization in Swine

The video describes in detail the catheterization of the distal brachial artery in swine. This technique enables researchers to measure arterial blood pressure continuously and collect arterial blood samples to assess arterial blood gas measurements. Arterial blood pressures and arterial blood gases are important physiological parameters to monitor during experimental procedures. In swine, four common methods of arterial catheterization have been described, including catheterization of the carotid, femoral, auricular, and medial saphenous arteries. Each of these techniques have advantages, such as ease of access for the auricular artery, and disadvantages that include deep tissue dissection for carotid artery catheterization. The described alternative method of arterial catheterization in swine, the catheterization of the distal aspect of the brachial artery, is a rapid procedure that requires relatively minimal tissue dissection and provides information that is in line with data collected from other arterial catheterization sites. The procedure uses a medial approach along an oblique plane of the lower brachium, positioned between the olecranon and the flexor aspect of the elbow joint, and this approach allows researchers the major advantage of unimpeded freedom for procedures that involve the caudoventral, caudodorsal back, or hind limbs of the pig. Due to the location of the upper forelimb of the catheterized vessel and potential challenges of effective homeostasis following catheter removal from the artery, this technique may be limited to non-recovery procedures.

The video describes in detail the catheterization of the distal brachial artery in swine. This procedure accurately measures arterial blood pressure and is a simple and fast method to collect samples for arterial blood gas measurements.

猪的臂动脉插管

The video describes in detail the catheterization of the distal brachial artery in swine. This technique enables researchers to measure arterial blood ...

Murine Myocardial Infarction Model using Permanent Ligation of Left Anterior Descending Coronary Artery

Myocardial infarction (MI) and acute coronary diseases are among the most prominent causes of death in population with western lifestyle. The murine models of MI with permanent ligation of left-anterior descending (LAD) coronary artery closely mimics MI in humans. Murine models benefit from the extensive genetic engineering available nowadays. Here we propose a reproducible murine surgical model of myocardial infarction by permanent LAD coronary ligation. Our technique comprises anesthesia with ketamine/xylazine that can be rapidly reversed by administration of an antagonist, intubation without tracheotomy for mechanical-assisted ventilation, ventilation with application of extrinsic positive end-expiratory pressure (PEEP) to avoid alveolar collapse, a thoracotomy method limiting to the minimum surgical lesions made to skeletal muscles, and lung inflation without thoracentesis. This method is sparsely invasive, reproducible and reduces post-surgery mortality and complications.

Herein we describe a surgical procedure showing how to achieve permanent ligation of the left-anterior descending coronary artery in mice. This model is of high relevance to investigate the pathophysiology of myocardial infarction and the concomitant biological processes.

使用左前部降冠动脉的永久结扎的月心肌梗死模型

Myocardial infarction (MI) and acute coronary diseases are among the most prominent causes of death in population with western lifestyle. The murine ...

A Large Animal Model for Acute Kidney Injury by Temporary Bilateral Renal Artery Occlusion

Acute kidney injury (AKI) is associated with higher risk for morbidity and mortality post-operatively. Ischemia-reperfusion injury (IRI) is the most common cause of AKI. To mimic this clinical scenario, this study presents a highly reproducible large animal model of renal IRI in swine using temporary percutaneous bilateral balloon-catheter occlusion of the renal arteries. The renal arteries are occluded for 60 min by introducing the balloon-catheters through the femoral and carotid artery and advancing them into the proximal portion of the arteries. Iodinated contrast is injected in the aorta to assess any opacification of the kidney vessels and confirm the success of the artery occlusion. This is furtherly confirmed by the flattening of the pulse waveform at the tip of the balloon catheters. The balloons are deflated and removed after 60 min of bilateral renal artery occlusion, and the animals are allowed to recover for 24 h. At the end of the study, plasma creatinine and blood urea nitrogen significantly increase, while eGFR and urine output significantly decrease. The need for iodinated contrast is minimal and does not affect renal function. Bilateral renal artery occlusion better mimics the clinical scenario of perioperative renal hypoperfusion, and the percutaneous approach minimizes the impact of the inflammatory response and the risk of infection seen with an open approach, such as a laparotomy. The ability to create and reproduce this clinically relevant swine model eases the clinical translation to humans.

This study presents a highly reproducible large animal model of renal ischemia-reperfusion injury in swine using temporary percutaneous bilateral balloon-catheter occlusion of the renal arteries for 60 min and reperfusion for 24 h.

临时双性肾动脉闭塞的急性肾损伤大型动物模型

Acute kidney injury (AKI) is associated with higher risk for morbidity and mortality post-operatively. Ischemia-reperfusion injury (IRI) is the most ...

A Rodent Model of The Ross Operation: Syngeneic Pulmonary Artery Graft Implantation in A Systemic Position

The Ross operation for aortic valve disease has regained new interest due to its outstanding long-term results. Nonetheless, when employed as freestanding root replacement, the possible dilation of the pulmonary autograft and subsequent aortic regurgitation is described. Several animal models have been proposed. However, these are usually limited to ex-vivo models or in-vivo experiments with relatively expensive large animal models. In this study, we sought to establish a rodent model of pulmonary artery graft (PAG) implantation in a systemic position. A total of 39 adult Lewis rats were included. Immediately after euthanasia, the pulmonary root was harvested from a donor animal (n=17). Syngeneic recipient (n=17) and sham-operated (n=5) rats were sedated and ventilated. In the recipient group, the PAG was implanted with an end-to-end anastomosis in infra-renal abdominal aortic position. Sham-operated rats underwent only transection and re-anastomosis of the aorta. Animals were followed with serial ultrasound studies for two months and post-mortem histological analysis. The median PAG diameter in the native position was 3.20 mm (IQR=3.18-3.23). At follow-up, the median diameter of the PAG was 4.03 mm (IQR=3.74-4.13) at 1 week, 4.07 mm (IQR=3.80-4.28) at 1 month, and 4.27 mm (IQR=3.90-4.35) at 2 months (p&lt;0.01). Peak systolic velocity was 220.07 mm/s (IQR=210.43-246.41) at 1 week, 430.88 mm/s (IQR=375.28-495.56) at 1 month, and 373.68 mm/s (IQR=305.78-429.81) at 2 months (p=0.02) and did not differ from the sham-operated group at the end of the experiment (p=0.5). Histological analysis did not show any sign of endothelial thrombosis. This study showed that rodent models may allow for the evaluation of the long-term adaptation of the pulmonary root to a high-pressure system. A systemically placed syngeneic PAG implantation represents a simple and feasible platform for the development and evaluation of novel surgical techniques and drug therapies to further improve the outcomes of the Ross operation.

We demonstrate how to establish a murine model of pulmonary root implantation into the descending aorta to simulate the Ross procedure. This model enables the medium/long-term evaluation of pulmonary autograft remodeling in a systemic position, representing the basis of developing therapeutic strategies to promote its adaptation.

罗斯手术的啮齿动物模型:全身位置的同源肺动脉移植植入

The Ross operation for aortic valve disease has regained new interest due to its outstanding long-term results. Nonetheless, when employed as freestanding ...